Medications for Insomnia

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

If you have insomnia, medication may be prescribed to help you sleep. Medication should be used only in combination with good sleep practices and/or behavioral changes. In general, sleep-promoting medications should be reserved for short term or occasional use. Studies have shown that the best therapies for lasting improvement in sleep involve the use of behavioral changes and techniques learned from cognitive behavioral therapy. Consult with your doctor before taking over-the-counter medications to make sure they will not interfere with sleep or interact with other medications you take.

Over-the-Counter Medications

Prescription Medications

Benzodiazepine
Hypnotics

Common names include:

Flurazepam

Triazolam

Estazolam

Temazepam

Hypnotics, or sedatives, are drugs that cause relaxation and help induce and maintain sleep. They affect chemicals in the brain that may be out of balance and causing the insomnia. These drugs are for short-term use. In any situation where long-term use is required, use should be closely monitored by your doctor. These drugs can react with other drugs you may be taking. Before starting a benzodiazepine hypnotic, tell your doctor about any and all drugs, vitamins, herbs, and supplements you are taking. Do not take any medications unless your doctor approves them.

Before using these drugs, tell your doctor if you have any of these conditions:

Nonbenzodiazepine hypnotics are structurally different than benzodiazepines hypnotics. They are most useful for inducing sleep. Before starting a nonbenzodiazepine hypnotic, tell your doctor about any and all drugs (including herbs and natural supplements) you are taking. Do not take any medications unless your doctor approves them.

Before using these drugs, tell your doctor if you have any of these conditions:

Drug allergies

History of
drug
or
alcohol addiction

Depression
or suicidal thoughts

Liver disease

Kidney disease

Asthma,
bronchitis,
emphysema, or other lung diseases

Myasthenia gravis

Sleep apnea

Presently are pregnant or are trying to become pregnant

These medications will make you sleepy and perhaps lightheaded. When taking one of these drugs, use the following guidelines:

Do not drive, operate machinery, or do any hazardous activities.

Take the medication just before going to bed.

Do not drink alcohol while taking hypnotics.

Do not take this medication unless you are able to get adequate rest before you must become active again.

Do not stop taking the drug suddenly if you have been taking it for several days or longer.

Ramelteon binds to specific melatonin receptors to induce sleep. Unlike other hypnotics, Ramelteon has not shown any potential for dependence or abuse. Because of this, Ramelteon can be used as long-term therapy for insomnia. Before starting a melatonin receptor hypnotic, tell your doctor about any and all drugs (including herbs and natural supplements) you are taking. Do not take any medications unless your doctor approves them.

Before using these drugs, tell your doctor if you have any of these conditions:

Moderate or severe liver disease

History of
alcohol addiction

Sleep apnea

Take fluvoxamine for obsessive-compulsive or social anxiety disorders

Presently are pregnant or are trying to become pregnant

When taking one of these drugs, use the following guidelines:

Do not drive, operate machinery, or do any hazardous activities.

Take the medication
just before going to bed.

Do not take with high-fat or heavy meals.

Do not drink alcohol while taking hypnotics.

Do not take this medication unless you are able to get adequate rest before you must become active again.

Possible side effects include:

Allergic reaction

Drowsiness, lightheadedness, or clumsiness

Headache

Fatigue

Behavioral changes, including worsening of depression

Residual effects from previous night's dosing, such as memory problems and irritation

Sedating Antidepressants

Common names include:

Amitriptyline

Doxepin

Trimipramine

Nefazodone

Trazodone

Mirtazapine

Sedating antidepressants work by treating the underlying depression that may be the cause of the insomnia, while at the same time having a sedative effect. While there are many medications for depression, sedating antidepressants may be helpful for people who have both insomnia and depression.

Before starting an antidepressant, tell your doctor about any and all drugs (including herbs and natural supplements) you are taking. Do not take any medications unless your doctor approves them.

Before using these drugs, tell your doctor if you have any of these conditions:

Over-the-Counter Medications

Antihistamine

Common medications include:

Diphenhydramine

Doxylamine

An antihistamine is a medication that blocks an allergic reaction in the body. Because one of its side effects is drowsiness, it is sometimes used to induce sleep. This and any other over-the-counter sleep aid should be taken only with the approval of your doctor. It can be taken with or without food, and with a full glass of water. These drugs can react with other drugs you may be taking. Before taking an antihistamine, tell your doctor about any drugs you are taking.

Before using these drugs, tell your doctor if you have any of these conditions:

Special Considerations

Take your medication as directed. Do not change the amount or the schedule.

Ask what side effects could occur. Report them to your doctor.

Some medications can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one medication. This includes over-the-counter medication, herbs, and supplements.

When to Contact Your Doctor

Hypnotics and sedating antidepressants can have side effects. Call your doctor right away if you experience:

Fast or irregular heart beat

Chest pain or pressure

Trouble breathing

High blood pressure

Difficulty urinating

Many of these medications need to be tapered off when stopping them. Stopping your medication abruptly can lead to “rebound insomnia,” which worsens your condition. Talk your doctor before stopping your medication.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.